The prevalence
of sickle cell anemia and Rhesus factor comparability have increased overtime
time in Nigeria; thus causing an increase in mortality rate among children
especially those below twenty (20) years of age (Kulkarni, 2007). It is widely
believe that the causes of sickle cell anemia and Rhesus factor incompatibility
is due to a high level of ignorance on the dangers posed by these disease. The
federal government of Nigeria through the NGOs and the media has put in so much
effort on awareness campaign on how to control the occurrence of these diseases
especially for the young ones that are about the ages of getting married.

Sickle
cell disease (SCD) can simply be defined as a hereditary disorder in which an
individual has inherited two abnormal Hb genes, at least one of which is
responsible for the production of sickle Hb (HbS) (Creary et al., 2007). The
most common clinical phenotype is the homozygote, i.e. HbSS, also known as
sickle cell anaemia. Compound heterozygotes include HbSC, SD, SO-Arab and
Sbthal, which are all collectively (in addition to SS) referred to as SCD.

The
sickle-shaped red blood cells described by Herrick caused several
complications, including chronic anemia, vaso-occlusive pain episodes, ischemic
organ damage, infections, small stature, and delayed puberty (Barakat et al.,
2008). For many generations sickle cell disease has been a prevalent disorder
in Nigeria. Reports show that sickle cell disease was a well-known disorder in
most states in Nigeria and that the natives in Nigeria had several local names
for this disease before it was discovered in America (Reid & Rodgers,
2007).

According
to Modell B, (2007) stated that the HbS gene became prevalent in different
parts of the world following selective pressure because the heterozygote (HbAS)
is protected against some of the deleterious effects of malaria. Therefore, SCD
is found at its highest frequencies in parts of the world where malaria is or
was endemic. In the same vein, Fleming AF, (2008) stated that because of slave
trade and recent migrations, it is now found even more widely including in
Europe and the USA. Nonetheless, the prevalence is highest in tropical Africa
and, indeed, the country with the highest burden is Nigeria where the trait
occurs in 25–30% and sickle cell anaemia occurs in approximately 2% of all
births

The
most common features of SCD are chronic haemolytic anaemia and recurrent
vaso-occlusion. The latter is responsible for the painful crises that
characterise the disease. There is also a chronic vasculopathy triggered by
free heme resulting in nitric oxide scavenging and upregulation of adhesion
molecules in reticulocytes, neutrophils and endothelial cells (Wood KC, 2008).
This is further complicated by a procoagulant state following the activation of
platelets. There is smooth muscle dystonia and eventual hyperplasia, which
contributes to vascular occlusions (Morris CR, 2009). This explains the
plethora of features and complications seen in SCD. The major cause of
mortality in childhood is overwhelming bacterial infections especially due to
encapsulated organisms, principally pneumococcus.

On
the other hand Rh is short for Rhesus blood group system. The Rh blood type
contains parts called antigens including the D antigen. If the D antigen is
present, a person is considered to be Rh positive. If the D antigen is absent,
the person is said to be Rh negative. About 85% of Nigerians have an Rh
positive blood type, while the remaining 15% are Rh negative. The Rhesus factor
is very important to the human body; however there might variation in
compatibility which results to Rhesus disease.

A
study of Rh disease deepens our understanding of historical infant mortality in
general and perinatal mortality in particular. The decline of infant mortality
in Nigeria started around 1800, which is earlier than in most other countries.
At that time, rates were very high even if the Nigerians as well as other
African countries levels were low in international comparison (Edvinsson et al.
2008). However there have been several awareness campaigns on the sickle cell
disease and Rhesus factor comparability among couples in Nigeria. The use of
mass media and other medium may help in the dissemination of information on
sickle cell and Rhesus factor among couples in Nigeria.

1.2 STATEMENT OF
PROBLEM